超声三步法快速筛查胎儿先天性心脏畸形的临床价值  

Clinical value of three-step ultrasonography in quickly screening fetal congenital heart defects

作　　者：贾赛玉 王跃涛[2] 王冬艳[2] 虞斌 欧阳俊 沈晓慧 韩笑 

机构地区：[1]南京医科大学附属常州妇幼保健院超声科,江苏常州213000 [2]苏州大学附属第三医院(常州市第一人民医院)核医学科 [3]南京医科大学附属常州妇幼保健院实验室,江苏常州213000 [4]南京医科大学附属常州妇幼保健院病理科,江苏常州213000

出　　处：《江苏医药》2018年第2期162-165,F0002,共5页Jiangsu Medical Journal

基　　金：江苏省妇幼保健科研资助项目(F201444);常州市卫计委指导性科研资助项目(WZ201411);江苏省重点研究计划(社会发展)项目(BE2017650);常州市科技支撑计划(社会发展)资助项目(CE20175021)

摘　　要：目的探讨超声三步法快速筛查胎儿先天性心脏畸形(CHD)的临床应用价值。方法回顾性分析75例孕16~28周孕妇的产前产后资料。以胎儿超声心动图为参考标准,评估同期超声三步法对胎儿CHD的诊断效能。结果 75例孕妇中,超声心动图检出CHD胎儿60例;超声三步法检出CHD胎儿57例,漏诊3例,误诊3例。超声三步法快速筛查与胎儿超声心动图具有较好的一致性(Kappa值为0.75,P<0.01);超声三步法筛查胎儿CHD灵敏度为95%,特异度为80%,准确度为92%,阳性预测值为95%,阴性预测值为80%。超声三步法对胎儿CHD的病因诊断与胎儿超声心动图结果一致者45例,诊断符合率为79%(45/57)。结论超声三步法快速筛查胎儿CHD有较高的灵敏度和准确度,操作简便,可作为胎儿CHD的筛查方法。Objective To study the clinical value of three-step ultrasonography in quickly screening fetal congenital heart defects （CHD）. methods The pre-and postnatal data of fetal echocardiography and three-step ultrasonography from 75 pregnant women with 16-28 gestationa[ weeks were retrospectively analyzed. Taking the reports of fetal echocardiography as the reference standards, the diagnostic efficiency of three-step ultrasonography for screening fetal CHD was analyzed. Results Of 75 pregnant women, fetal CHD were reported by echocardiography in 60 cases and by three-step ultrasonography in 57 cases. Three fetuses with CHD missed the diagnosis of CHD and 3 CHD fetuses were misdiagnosed in 75 pregnant women examined by three-step ultrasonography. Both of three-step ultrasonography and fetal echocardiography in screening fetal CHD had a good consistency （Kappa value = 0.75, P〈0.01 ）. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of three-step ultrasonography in screening fetal CHD were 95 %, 80 %, 92 X, 95 % and 80 %, respectively. The coincidence rate was 79% （45/57） in the CHD diagnosis by three-step ultrasonography and fetal echocardiography. Conclusion Three-step ultrasonography has higher sensitivity and accuracy in quickly screening CHD, which is easy to practice and can be used as a method of screening for fetal CHD.

关 键 词：超声 先天性心脏畸形 胎儿 

分 类 号：R445[医药卫生—影像医学与核医学]